1. Field of the Invention
This invention relates to surgical devices in general.
More particularly, the invention relates to a magazine-loaded suturing device of the type using suturing clips, and to a magazine for use with such a device.
Still more specifically, this invention relates to a suturing device and a magazine of the type under discussion, wherein the suturing clips are automatically advanced to their position of use.
2. The Prior Art
Certain types of suturing are still, and probably always will be, performed by hand. Other types of suturing, however, such as skin sutures and hemostatic sutures, are performed with the aid of staple-like metal clips which are driven into the skin or, in the case of hemostatic clips, tightly squeezed about a blood vessel to stop the flow of blood through the same.
The invention will hereafter be described for purposes of explanation with reference to hemostatic applications. It should be understood, however, that it has more general applicability in the field of surgical suturing. It should also be understood that the term "suturing" as used herein is intended to carry the broadest meaning, i.e. to embrace hemostatic, skin, as well as other types of suturing in which suturing clips are employed.
In the prior art it is known to employ e.g. hemostatic forceps which are individually loaded with clips. In practice this means that at least two forceps may be used during the suturing operation: while the surgeon applies a hemostatic clip to a bloodvessel with one forceps, an assistant (nurse) standing behind him inserts a single clip between the jaws of the second forceps, ready for use. The surgeon hands the used forceps back over his shoulder to be reloaded and the assistant hands him the newly loaded forceps in exchange. This exchange continues until suturing is completed. It is self-evident that this procedure is not very efficient, it ties up the assistant who could be performing some other function, and (particularly important in an emergency) it slows the surgeon down.
A proposal has been made to provide a magazine-loaded hemostatic forceps with semi-automatic clip feed. This has not found acceptance because the surgeon is required to perform a "cocking" operation after each clip is set; it is this operation which advances the next clip to operative position. Aside from the obvious disadvantage inherent in the lack of a fully automatic feed, the cocking motion is cumbersome and puts a strain on the surgeon's hands, which is definitely undesirable in terms of his steadiness and accuracy.
Solutions proposed in the stapler art, for devices used in closing boxes and the like, have been found not to be workable in the medical field. Suturing equipment is precision surgical equipment which must be small (there is the problem of access to certain wound areas), light (so as not to tire the surgeon and to permit ready manipulation) and sterilizable. The known staple solutions cannot be successfully integrated in equipment having to meet these requirements. A drastic departure from the prior art solutions is therefore required to arrive at the desired goal.